Early morning physical activity is associated with healthier white matter microstructure and happier children: the ActiveBrains project

The background of this study is to examine the associations of individual and combined early morning patterns (i.e., active commuting to school, physical activity before school, having breakfast and good sleep) with white matter microstructure (WMM) and, whether the associated white mater microstructure outcomes were related to mental health outcomes in children with overweight or obesity. 103 children with overweight or obesity (10.0 ± 1.1 years old, 42 girls) from the ActiveBrains project participated in this cross-sectional study. Early morning patterns and mental health indicators (i.e., self-esteem, optimism, positive and negative affect, stress, depression and anxiety) were self-reported by the children using validated questionnaires. WMM was assessed by magnetic resonance imaging using diffusion tensor imaging. When examined independently, early morning patterns were not related with WMM (all P > 0.05). However, the combination of early morning patterns was related with WMM (P < 0.05). Specifically, physically active early morning patterns (i.e., active commuting to school and physical activity before school) were associated with global fractional anisotropy (FA) (β = 0.298, P = 0.013) and global radial diffusivity (RD) (β = − 0.272, P = 0.021), as well as with tract-specific FA (β = 0.314, P = 0.004) and RD (β = − 0.234, P = 0.032) in the superior longitudinal fasciculus (SLF). Furthermore, combined physically active early morning pattern-associated global (i.e., FA and RD) and tract-specific (i.e., FA and RD in the SLF) WMM indicators were positively associated with happiness (β absolute value range from 0.252 to 0.298, all P < 0.05). A combination of physically active early morning patterns may positively relate to white matter microstructure in children with overweight or obesity, and, in turn, happiness.Universidad de Granada/CBUASpanish Government DEP2013-47540 BES-2014-068829 DEP2016-79512-R PSI2012-3929Alicia Koplowitz FoundationMinistry of Science and Innovation, Spain (MICINN) Spanish Government RYC-2011-09011 RYC2019-027287-IUniversity of GranadaJunta de Andalucia, Consejeria de Conocimiento, Investigacion y Universidades and European Regional Development Fund (ERDF) SOMM17/6107/UGREXERNET Research Network on Exercise and Health in Special Populations DEP2005-00046/ACTISAMID III networkRETICS PN I + D + I 2017-2021ISCIII-Sub -Directorate General for Research Assessment and PromotionEuropean Commission SOMM17/6107/UGR RD16/0022Universidad de Granada/CBU

The influence of adherence to the Mediterranean diet on academic performance is mediated by sleep quality in adolescents

Aim: This study examined the association of adherence to the Mediterranean diet with academic performance and tested whether this association was mediated by sleep in Spanish adolescents. Methods: We recruited 269 adolescents (52% boys) aged 13.9 ± 0.3 years from the Deporte, ADOlescencia y Salud study of 38 secondary schools and sport clubs in Castellon, Spain, between February and May 2015. Adherence to the Mediterranean diet was assessed by the KIDMED questionnaire, sleep quality was evaluated with the Pittsburgh Sleep Quality Index test and sleep duration was objectively computed using a wrist-worn accelerometer. Academic performance was assessed through final school grades and a validated test. Results: Greater adherence to the Mediterranean diet was associated with higher scores in language, core subjects, grade point average and verbal ability (p < 0.05). Sleep quality acted as a significant mediator of the association between adherence to the Mediterranean diet and final grades in maths, language, core subjects and the grade point average. Conclusion: Our data show that the influence of adherence to the Mediterranean diet on academic performance was mediated by sleep quality in adolescents. Education and public health professionals should work together to achieve both improved health status and academic performance in adolescents

Commentary: At least eighty percent of brain grey matter is modifiable by physical activity: a review study

A commentary on At least eighty percent of brain grey matter is modifiable by physical activity: a review study by Batouli, S. A. H., and Saba, V. (2017). Behav. Brain Res. 332, 204–217. doi: 10.1016/j.bbr.2017.06.002IE-C is supported by a grant from the Alicia Koplowitz Foundation

Neck circumference and clustered cardiovascular risk factors in children and adolescents: Cross-sectional study

Objective Early detection of cardiovascular disease (CVD) risk factors, such as obesity, is crucial to prevent adverse long-term effects on individuals'' health. Therefore, the aims were: (1) to explore the robustness of neck circumference (NC) as a predictor of CVD and examine its association with numerous anthropometric and body composition indices and (2) to release sex and age-specific NC cut-off values to classify youths as overweight/obese. Design Cross-sectional study. Setting 23 primary schools and 17 secondary schools from Spain. Participants 2198 students (1060 girls), grades 1-4 and 7-10. Measures Pubertal development, anthropometric and body composition indices, systolic and diastolic blood pressure (SBP and DBP, respectively), cardiorespiratory fitness, blood sampling triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), glucose and inflammatory markers. Homoeostasis model assessment (HOMA-IR) and cluster of CVD risk factors were calculated. Results NC was positively correlated with all anthropometric and body composition indices. NC was negatively associated with maximum oxygen consumption (R 2 =0.231, p<0.001 for boys; R 2 =0.018, p<0.001 for girls) and positively associated with SBP, DBP, TC/HDL-c, TG, HOMA, complement factors C-3 and C-4, leptin, adiponectin and clustered CVD risk factor in both sexes (R 2 from 0.035 to 0.353, p<0.01 for boys; R 2 from 0.024 to 0.215, p<0.001 for girls). Moreover, NC was positively associated with serum C reactive protein, LDL-c and visfatin only in boys (R 2 from 0.013 to 0.107, p<0.05). Conclusion NC is a simple, low-cost and practical screening tool of excess of upper body obesity and CVD risk factors in children and adolescents. Paediatricians can easily use it as a screening tool for overweight/obesity in children and adolescents. For this purpose, sex and age-specific thresholds to classify children and adolescents as normal weight or overweight/obese are provided

Physical activity, sedentary time, and fitness in relation to brain shapes in children with overweight/obesity: Links to intelligence

Funding information Additional support was obtained from the Alicia Koplowitz Foundation (grant number, ALICIAK-2018), University of Granada, Plan Propio de Investigación 2016, Excellence actions: Units of Excellence, Unit of Excellence on Exercise and Health (UCEES), the Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades; and under the umbrella of the European Union's Horizon 2020 research and innovation programme (grant number, 667302); the SAMID III network, RETICS, funded by the; C.C.-S. is supported by a grant from the Spanish Ministry of Science and Innovation (grant number, FJC2018-037925-I) and by a grant from the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska Curie grant agreement No 101028929.; IEC is supported by the Spanish Ministry of Science and Innovation (grant number, RYC2019-027287-I).; J.H.M. is supported by the Spanish Ministry of Education, Culture and Sport (grant number, FPU15/02645) and by the Swedish Research Council for Health, Working Life and Welfare (2012–00036).; J.V.-R. is supported by the Spanish Ministry of Science, Innovation and Universities (grant numbers, FJCI-2017-33396 & IJC2019-041916-I).; This project was funded by the Spanish Ministry of Economy and Competitiveness and the “Fondo Europeo de Desarrollo Regional (FEDER)” (grant numbers, DEP2013-47540, DEP2016-79512-R, DEP2017-91544-EXP, and RYC- 2011-09011)Objectives: To examine the association between physical activity, sedentary time, and physical fitness with the shapes of subcortical brain structures in children with overweight/obesity. Further, we analyzed whether differences in the shapes of subcortical brain structures were related to intelligence. We hypothesized that those children with higher physical activity levels, lower sedentary time, and better fitness, would show greater expansion of the brain regions analyzed, and these expansions would be associated with higher intelligence. Study design: 100 children (10.0 ± 1.1 years, 40 girls) were included in the analyses. Physical activity and sedentary time were measured by accelerometry, and physical fitness was evaluated by a fitness battery. Shapes of subcortical brain structures were assessed by magnetic resonance imaging. Intelligence was measured by the Kaufmann Brief Intelligence test. Results: Physical activity was related to expansion of the right/left pallidum, right/left putamen, and right thalamus (p < 0.05). Higher sedentary time was related to contraction of the left thalamus and right nucleus accumbens (p < 0.05). Higher levels of cardiorespiratory fitness were associated with expansion of the right amygdala (p = 0.022). Greater strength in the upper-limb was related to expansion of the right/left pallidum and the left nucleus accumbens (p < 0.038), and contraction of the left amygdala (p = 0.030). Better speed-agility was associated with expansion of the left nucleus accumbens (p = 0.036). Physical activity- and fitness-related expansion of the right pallidum was associated with higher intelligence (all p < 0.05). Conclusion: Physical activity, sedentary time, and physical fitness were significantly related to the shapes of subcortical brain structures, which in turn were related to intelligence in children with overweight/obesity. Keywords: brain shapes; cardiorespiratory fitness; cognitive performance; gray matter; moderate-to-vigorous; muscular strength; sedentarism; speed-agility.Alicia Koplowitz Foundation (grant number, ALICIAK-2018)University of Granada, Plan Propio de Investigación 2016Excellence actions: Units of Excellence, Unit of Excellence on Exercise and Health (UCEES), the Junta de Andalucía, Consejería de Conocimiento, Investigación y UniversidadesEuropean Union's Horizon 2020 research and innovation programme (grant number, 667302)SAMID III network, RETICSSpanish Ministry of Science and Innovation (grant number, FJC2018-037925-I)European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska Curie grant agreement No 101028929Spanish Ministry of Science and Innovation (grant number, RYC2019-027287-I)Spanish Ministry of Education, Culture and Sport (grant number, FPU15/02645)Swedish Research Council for Health, Working Life and Welfare (2012–00036)Spanish Ministry of Science, Innovation and Universities (grant numbers, FJCI-2017-33396 & IJC2019-041916-I)Spanish Ministry of Economy and Competitiveness and the “Fondo Europeo de Desarrollo Regional (FEDER)” (grant numbers, DEP2013-47540, DEP2016-79512-R, DEP2017-91544-EXP, and RYC- 2011-09011)Funding for open access charge: Universidad de Granada/CBU

Associations of objectively-assessed physical activity and sedentary time with hippocampal gray matter volume in children with overweight/obesity

This study investigated physical activity (PA) and sedentary time (SED) in relation to hippocampal gray matter volume (GMV) in pediatric overweight/obesity. Ninety-three children (10 ± 1 year) were classified as overweight, obesity type I, or type II–III. PA was assessed with non-dominant wrist accelerometers. GMV was acquired by magnetic resonance imaging (MRI). Neither PA nor SED associated with GMV in the hippocampus in the whole sample (p > 0.05). However, we found some evidence of moderation by weight status (p < 0.150). Moderate-to-vigorous PA (MVPA) positively associated with GMV in the right hippocampus in obesity type I (B = 5.62, p = 0.017), which remained when considering SED, light PA, and sleep using compositional data (γ = 375.3, p = 0.04). Compositional models also depicted a negative association of SED relative to the remaining behaviors with GMV in the right hippocampus in overweight (γ = −1838.4, p = 0.038). Reallocating 20 min/day of SED to MVPA was associated with 100 mm3 GMV in the right hippocampus in obesity type I. Multivariate pattern analysis showed a negative-to-positive association pattern between PA of increasing intensity and GMV in the right hippocampus in obesity type II–III. Our findings support that reducing SED and increasing MVPA are associated with greater GMV in the right hippocampus in pediatric overweight/obesity. Further studies should corroborate our findings.MINECO/FEDER DEP2013-47540 DEP2016-79512-R RYC-2011-09011Spanish Ministry of Education, Culture and Sport FPU15/02645 FPU17/04802Government of Andalusian, Integrated Territorial Initiative 2014-2020 for the province of Cadiz PI-0002-2017Spanish Government FJC2018-037925-IAlicia Koplowitz FoundationSpanish Ministry of Economy and Competitiveness RTI2018-095284-J-100University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of ExcellenceScientific Excellence Unit on Exercise and Health (UCEES)Junta de AndaluciaConsejeria de Conocimiento, Investigacion y UniversidadesEuropean Union (EU)SAMID III network, RETICS - PN I + D+I 2017-2021 (Spain)ISCIII-Sub-Directorate General for Research Assessment and PromotionEuropean Union (EU) RD16/0022EXERNET Research Network on Exercise and Health in Special Populations DEP2005-00046/ACT

Physical activity and amyloid beta in middle-aged and older adults:A systematic review and meta-analysis

Background: One of the pathological hallmarks distinguishing Alzheimer's disease from other dementias is the accumulation of amyloid beta (Aβ). Higher physical activity is associated with decreased dementia risk, and one potential path could be through Aβ levels modulation. We aimed to explore the relationship between physical activity and Aβ in middle-aged and older adults. Methods: A systematic search of PubMed, Web of Science, PsycINFO, Cochrane Central Register of Controlled Trials, and SPORTDiscus was performed from inception to the 28th of April 2022. Studies were eligible if they included physical activity and Aβ data in adults aged 45 years or older. Multi-level meta-analyses of intervention and observational studies were performed to examine the role of physical activity in modulating Aβ levels. Results: In total, 37 articles were included (8 randomized controlled trials, 3 non-randomized controlled trials, 4 prospective longitudinal studies, and 22 cross-sectional studies). The overall effect size of physical activity interventions on changes in blood Aβ was medium (pooled standardized mean difference = –0.69, 95% confidence interval (95%CI): –1.41 to 0.03; I2 = 74.6%). However, these results were not statistically significant, and there were not enough studies to explore the effects of physical activity on cerebrospinal fluid (CSF) and brain Aβ. Data from observational studies were examined based on measurements of Aβ in the brain using positron emission tomography scans, CSF, and blood. Higher physical activity was positively associated with Aβ only in the CSF (Estimate r = 0.12; 95%CI: 0.05–0.18; I2 = 38%). Conclusion: Physical activity might moderately reduce blood Aβ in middle-aged and older adults. However, results were only near statistical significance and might be interpreted with caution given the methodological limitations observed in some of the included studies. In observational studies, higher levels of physical activity were positively associated with Aβ only in CSF. Therefore, further research is needed to understand the modulating role of physical activity in the brain, CSF, and blood Aβ, as well as its implication for cognitive health.</p

Physical activity and amyloid beta in middle-aged and older adults:A systematic review and meta-analysis

Background: One of the pathological hallmarks distinguishing Alzheimer's disease from other dementias is the accumulation of amyloid beta (Aβ). Higher physical activity is associated with decreased dementia risk, and one potential path could be through Aβ levels modulation. We aimed to explore the relationship between physical activity and Aβ in middle-aged and older adults. Methods: A systematic search of PubMed, Web of Science, PsycINFO, Cochrane Central Register of Controlled Trials, and SPORTDiscus was performed from inception to the 28th of April 2022. Studies were eligible if they included physical activity and Aβ data in adults aged 45 years or older. Multi-level meta-analyses of intervention and observational studies were performed to examine the role of physical activity in modulating Aβ levels. Results: In total, 37 articles were included (8 randomized controlled trials, 3 non-randomized controlled trials, 4 prospective longitudinal studies, and 22 cross-sectional studies). The overall effect size of physical activity interventions on changes in blood Aβ was medium (pooled standardized mean difference = –0.69, 95% confidence interval (95%CI): –1.41 to 0.03; I2 = 74.6%). However, these results were not statistically significant, and there were not enough studies to explore the effects of physical activity on cerebrospinal fluid (CSF) and brain Aβ. Data from observational studies were examined based on measurements of Aβ in the brain using positron emission tomography scans, CSF, and blood. Higher physical activity was positively associated with Aβ only in the CSF (Estimate r = 0.12; 95%CI: 0.05–0.18; I2 = 38%). Conclusion: Physical activity might moderately reduce blood Aβ in middle-aged and older adults. However, results were only near statistical significance and might be interpreted with caution given the methodological limitations observed in some of the included studies. In observational studies, higher levels of physical activity were positively associated with Aβ only in CSF. Therefore, further research is needed to understand the modulating role of physical activity in the brain, CSF, and blood Aβ, as well as its implication for cognitive health.</p

Physical fitness and white matter microstructure in children with overweight or obesity: the ActiveBrains project

Recent studies investigated the association of cardiorespiratory fitness with white matter microstructure in children, yet little work has explored to what extent other components of physical fitness (i.e., muscular or motor fitness) are associated with white matter microstructure. Indeed, this association has not been previously explored in children with overweight/obesity who present a different white matter development. Therefore, we aimed to examine associations between physical fitness components and white matter microstructure in children with overweight/obesity. In total, 104 (10.04 +/- 1.15 years old; 43 girls) children were included in this cross-sectional study. Physical fitness was assessed using the ALPHA-fitness test battery. Fractional anisotropy (FA) and mean diffusivity were derived from diffusion tensor imaging (DTI). No association was found between physical fitness and global DTI metrics (all P>0.082). Within individual tracts, all associations became non-significant when analyses were adjusted for multiple comparisons. Using the voxel-wise approach, we identified a small cluster in the left lateral frontal lobe where children with greater upper-body muscular fitness showed higher FA (PFWE-corrected=0.042). Although our results cannot conclude physical fitness is related to white matter microstructure in children with overweight/obesity; those findings indicate that the association of muscular fitness with white matter microstructure might be more focal on frontal areas of the brain, as opposed to global differences

Effects of an exercise program on brain health outcomes for children with overweight or obesity

Importance Pediatric overweight and obesity are highly prevalent across the world, with implications for poorer cognitive and brain health. Exercise might potentially attenuate these adverse consequences. Objectives To investigate the effects of an exercise program on brain health indicators, including intelligence, executive function, academic performance, and brain outcomes, among children with overweight or obesity and to explore potential mediators and moderators of the main effects of exercise. Design, Setting, and Participants All preexercise and postexercise data for this 20-week randomized clinical trial of 109 children aged 8 to 11 years with overweight or obesity were collected from November 21, 2014, to June 30, 2016, with neuroimaging data processing and analyses conducted between June 1, 2017, and December 20, 2021. All 109 children were included in the intention-to-treat analyses; 90 children (82.6%) completed the postexercise evaluation and attended 70% or more of the recommended exercise sessions and were included in per-protocol analyses. Interventions All participants received lifestyle recommendations. The control group continued their usual routines, whereas the exercise group attended a minimum of 3 supervised 90-minute sessions per week in an out-of-school setting. Main Outcomes and Measures Intelligence, executive function (cognitive flexibility, inhibition, and working memory), and academic performance were assessed with standardized tests, and hippocampal volume was measured with magnetic resonance imaging. Results The 109 participants included 45 girls (41.3%); participants had a mean (SD) body mass index of 26.8 (3.6) and a mean (SD) age of 10.0 (1.1) years at baseline. In per-protocol analyses, the exercise intervention improved crystallized intelligence, with the exercise group improving from before exercise to after exercise (mean z score, 0.62 [95% CI, 0.44-0.80]) compared with the control group (mean z score, –0.10 [95% CI, –0.28 to 0.09]; difference between groups, 0.72 SDs [95% CI, 0.46-0.97]; P < .001). Total intelligence also improved significantly more in the exercise group (mean z score, 0.69 [95% CI, 0.48-0.89]) than in the control group (mean z score, 0.07 [95% CI, –0.14 to 0.28]; difference between groups, 0.62 SDs [95% CI, 0.31-0.91]; P < .001). Exercise also positively affected a composite score of cognitive flexibility (mean z score: exercise group, 0.25 [95% CI, 0.05-0.44]; control group, –0.17 [95% CI, –0.39 to 0.04]; difference between groups, 0.42 SDs [95% CI, 0.13-0.71]; P = .005). These main effects were consistent in intention-to-treat analyses and after multiple-testing correction. There was a positive, small-magnitude effect of exercise on total academic performance (mean z score: exercise group, 0.31 [95% CI, 0.18-0.44]; control group, 0.10 [95% CI, –0.04 to 0.24]; difference between groups, 0.21 SDs [95% CI, 0.01-0.40]; P = .03), which was partially mediated by cognitive flexibility. Inhibition, working memory, hippocampal volume, and other brain magnetic resonance imaging outcomes studied were not affected by the exercise program. The intervention increased cardiorespiratory fitness performance as indicated by longer treadmill time to exhaustion (mean z score: exercise group, 0.54 [95% CI, 0.27-0.82]; control group, 0.13 [95% CI, –0.16 to 0.41]; difference between groups, 0.42 SDs [95% CI, 0.01-0.82]; P = .04), and these changes in fitness mediated some of the effects (small percentage of mediation [approximately 10%-20%]). The effects of exercise were overall consistent across the moderators tested, except for larger improvements in intelligence among boys compared with girls. Conclusions and Relevance In this randomized clinical trial, exercise positively affected intelligence and cognitive flexibility during development among children with overweight or obesity. However, the structural and functional brain changes responsible for these improvements were not identified